Background: Thyroid disease in pregnancy can have a profound impact on both mother and fetus. Guidelines on diagnosis and management are lacking in the UK and there is significant variation between European and US guidelines. This survey aimed to gather data on current management by endocrinologists in Scotland.
Methods: An online survey was created using Google Forms and emailed to endocrinology trainees and consultants in Scotland (April 2019). The survey questioned management of hypothyroidism and Graves disease in pregnancy. Submissions were anonymised and analysed.
Results: Forty two responses were received (27% target sample response rate) with 86% of all responses from consultants. Hypothyroidism: The majority (72%) of endocrinologists elect to treat SCH in pregnancy although there was variation in how this was defined. Only 45% work in centres where trimester-specific TFT ranges are available. Graves disease: 88% recommend women who conceive on carbimazole are switched to PTU in early pregnancy but only 40% recommend switching back to carbimazole in the second trimester. 57% of endocrinologists currently recommend definitive treatment (radioiodine or thyroidectomy) of Graves disease prior to pregnancy.
Conclusions: This survey demonstrates wide variation in current management of thyroid disease in pregnancy across Scotland. These results highlight the need for cohesive guidelines in the diagnosis and management of thyroid disease in pregnancy.